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Life as a Transgender Addict

It's easier to just sweep what's uncomfortable under the rug. Better not seen, not heard, not felt. Total oblivion, that's the name of the game.

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I, like many trans people, began using drugs and alcohol to cope with gender dysphoria.

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I am a trans woman.

You might be sitting here, reading this, and thinking to yourself: Okay. Congratulations! Good for you! I’m glad you had the courage to be yourself!

If you're like many people I've told, you're probably thinking something along these lines. But you're probably also thinking, what relevance does this have? Does this belong on a site revolving around drug and alcohol addiction, harm reduction, and other related issues?

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You'd be justified in asking these questions. The quick answer is yes.

I, like many trans people, began using drugs and alcohol to cope with gender dysphoria. For those who don't know, gender dysphoria is what occurs when your body and brain are misaligned; when internally you just know that what your parents, teachers, and other kids are telling you is wrong. You want to grow your hair long, play with dolls, and wear dresses, damn it!

The rate of substance misuse in gay, lesbian, and bisexual people is twice that of heterosexual (straight) people. While reported rates of substance use disorder vary — the National Institute on Drug Abuse places the number for LGB substance abusers at 39.1 percent (versus 17.1 percent for the heterosexual population) — the disparity is higher when transgender folks are factored in, especially youth. The data is sparse, as transgender people are usually excluded from studies or grouped with other sexual minorities, but one study, for example, found that the "prevalence of substance use was 2.5-4 times higher for transgender youth compared with their nontransgender peers (depending on the substance)."

Why this disparity?

For one thing, even in folks like me (who report a higher overall satisfaction with life due to various sorts of privilege), there is still the issue of depression, body dysphoria, and societal pressure. All of these pressures combine together to form a boiling pot at times, for which the temporary relief of drugs and alcohol can seem like a godsend more than a vicious cycle from hell.

You use, you feel better for a short time. Then you return to reality, and all your issues are still there. Only now they're worse, because you haven't slept — or if you did sleep, you slept like shit. I'm sure many of you can relate.

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My drug of choice was prescription pills, specifically uppers. But as with most pill fiends, it's almost never limited to just one class of chemicals: I loved them all.

I was one of those “up three or four days, sleep another” types. I would take heavy amounts of amphetamines for several days and then eat a heroic dose of whatever benzodiazepines I could find. Xanax was ol’ reliable, but — as all benzodiazepines are practically the same effect-wise — any would do in a pinch. I had a prescription for both Adderall and Xanax at one point in my career as an addict, and I still found myself buying other benzodiazepines and extra Adderall, as well as other prescription stimulants and opioids.

Nothing was ever enough, and drugs were my security blanket. Speed gave me the confidence to go out in public — to not spend all my time isolated and fixating on the things I didn't like about my body — and downers were perfect for numbing myself to anything the speed didn't take care of.

My experience of using drugs to cope is why I'm a strong believer in the need for tolerance, especially when it comes to trans kids. We have such a high rate of self-hatred, and I know personally that one guaranteed way many members of the LGBT community deal with this is by getting numb. It's easier to just sweep what's uncomfortable under the rug. Better not seen, not heard, not felt. Total oblivion, that's the name of the game.

Practicing tolerance means we accept people and let them do what needs to be done — and will eventually happen anyway, except for those in the community for whom it all gets to be unbearable: a study from the American Academy of Pediatrics found that more than half of transgender male teens and 29.9 percent of transgender female teens have attempted suicide.

This simply does not need to happen. When trans children are accepted as their stated gender, the suicide rate decreases dramatically. If you could save someone's life, wouldn't you want to do whatever it takes to keep them from even considering ending it all? Suicide never has to be an option.

Since 2017, I've had three friends die, two by suicide and one under circumstances I still haven't cleared up. I don't know that I want to have the mystery solved.

She was a trans woman named Margot, and in the months leading up to her death, she had been in and out of hospitals, both for physical and mental issues. I can't say, with any confidence, whether her heart exploded or if she took herself out to avoid the extreme mistreatment she received from her family. And, judging by the area we both lived in and how bad it really can be, I'm not convinced it wasn't something more nefarious that resulted in her death.

As for my other two friends (neither of whom made any reference or gave any hint that they may or may not be trans), I can't tell you whether or not they were. Many of us are fantastic actors and so extraordinarily skilled at concealing such a crucial part of our identities, that even fellow trans people say, “I never would have guessed.” As far as I know, gender identity — that innate sense of who you are, which pervades every living being on this planet (whether or not you realize it) — may have been among the reasons they chose to take the quick exit out of here.

And all three of my friends struggled, to varying degrees, with addiction. It's no secret that substance use often worsens depression and other mental health conditions.

By accepting trans people and working together to end bigotry, we will not only tackle an underreported cause of substance misuse and addiction, but also fight depression, trauma, and other underlying conditions associated with deciding to use drugs and alcohol in the first place.

In many ways, when it comes to addiction, transitioning (the process of changing one's gender presentation and/or sex characteristics to accord with one's internal sense of gender identity) can almost be viewed as a form of harm reduction for people who need to go for it. I have many friends who, upon living as their true selves, realize even further that their substance abuse was closely tied to depression and self-hatred.

No one's path is ever going to be identical. I haven’t used any substances for over a month — the longest I've been clean in years, and I had to find my own way to do it. Transitioning isn't a cure-all, but it can help. The best hope we have is working together to reduce the trauma experienced by transgender people in their daily lives, even (especially) as children. Until society figures out how to recognize and accept this community — my community — we won’t make a dent in the rates of addiction or suicide.

Trust me on that.

If you or someone you know needs help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or Text HOME to 741741. For LGBTQ youth in crisis, call or visit The Trevor Project at 1-866-488-7386 or text START to 678678. If you think someone is in immediate danger, do not leave them alone, stay with them and call 911. Read about warning signs for suicide and more at mentalhealth.gov.

Stephanie Knarr lives in Pittsburgh, Pennsylvania. She works in telefunding and advocates for better treatment for LGBT people, the mentally ill, and folks with addiction. Her work has appeared in a variety of places, most recently Unwinnable and Faramira. She has an eight-year-old daughter.

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